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Acta Radiol. 2010 Dec;51(10):1111-9. doi: 10.3109/02841851.2010.520027. Epub 2010 Oct 7.

CT, MR, (18)F-FDG PET/CT, and their combined use for the assessment of mandibular invasion by squamous cell carcinomas of the oral cavity.

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  • 1Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.



a reliable assessment of mandibular invasion is crucial for treatment planning to obtain both radical tumor resection and good functional results.


to retrospectively compare the diagnostic value of three different imaging methods - computed tomography (CT), magnetic resonance (MR) imaging, (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT - and their combined use for detection of mandibular invasion by squamous cell carcinoma (SCC) of the oral cavity.


forty-six patients (39 men and 7 women; mean age, 59.4 years) suspected of having mandibular invasion by SCC of the oral cavity underwent CT, MR, and PET/CT within 2 weeks before surgery. First, each study was reviewed separately for the presence of mandibular invasion by tumors. Then, the value of combined images was assessed based on a confidence rating score for each modality assigned by observers. These results were verified with histopathologic findings.


HIstopathologic examination revealed mandibular invasion in 12 of 46 SCCs. The sensitivity, specificity, and accuracy were 41.7%, 100%, and 84.8% for CT; 58.3%, 97.1%, and 87.0% for MR; and 58.3%, 97.1%, and 87.0% for PET/CT, respectively. The comparison of these modalities showed no statistically significant difference among them (P > 0.05). The combination of CT, MR, and PET/CT improved sensitivity (83.3%), without loss of specificity (100%) and accuracy (95.7%), although the difference failed to reach statistical significance (P > 0.05).


the combined analysis of CT, MR, and PET/CT can improve sensitivity in the detection of mandibular invasion by SCC of the oral cavity.

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